Jolt of Reality Following the lead of elite athletes, teenagers are increasingly juicing their workouts with pills and powders-sometimes with tragic results

Sean Riggins and some of his friends at Lincoln (Ill.) Community High had a name for it: jacketing. Before wrestling meets or football practices or even on Saturday nights when they wanted a surge of quick energy, they would pop a yellow-and-black-striped capsule called a Yellow Jacket. The pill, perfectly legal, contained ephedra and caffeine, a combination that speeds up the metabolism. According to the package, it was an EXTREME ENERGIZER! The ritual of jacketing also entailed chasing the pill with a swig of Mountain Dew or Red Bull, both heavily caffeinated beverages. In retrospect, it was nuts. But wisdom can be hard-won when you're 16 and trying to make the varsity football team. ¬∂ Growing up in a sleepy town of 15,000, Sean was a jock for all seasons. He was a varsity wrestler as a freshman in 2001, had a black belt in taekwondo and, at a squat 5'6" and 170 pounds, delivered a mean hit as a linebacker. By all accounts Sean hardly cut a wild figure. His hair was closely cropped. He didn't smoke or drink.

He worked out religiously, deadlifting 425 pounds when he was a sophomore. The year before that, he started jacketing. "I'm sure he thought it was going to help him play better," says Will Gilmer, one of Sean's best friends and a member of the football and wrestling teams. "Knowing Sean, I'm sure he thought it was O.K."

Who could blame him? The product, labeled a dietary supplement, was available right at the counter of the Apollo, the local minimart. Sean had seen countless similar products advertised in the muscle magazines he read and on the pro wrestling telecasts he watched. Marshall Faulk, star running back of the St. Louis Rams, had endorsed a supplement containing ephedra before it was banned by the NFL. The Yellow Jacket label warned SALE TO MINORS IS PROHIBITED, but all the kids knew that there was no legal age restriction on buying supplements. And at $1.19 for a package of three, the price was right.

At some point last Labor Day, friends and teammates say, Sean took part in the jacketing ritual. He had a jayvee football game that night, but told the Railsplitters coaches he was feeling out of sorts. He dressed but spent the game looking glassy-eyed on the sideline, an ice pack on his head. Once he lay down near the team's bench. "He wasn't himself at all," recalls sophomore teammate Tim Reddix. Sean drove home with his parents and went to sleep that night, and when he woke up on Tuesday, saw a doctor. After interviewing Sean and being told that he had not taken any drugs, the doctor assumed that he was dealing with a case of the flu that was going around; he prescribed a decongestant and sent Sean home. A few hours later Sean went into cardiac arrest, and by that afternoon he was dead.

Eskimos need more ice. Liz Taylor needs more chins. And we need more sports cable networks. Five more-Ice Channel, Black Belt TV, Football Network, Tennis Channel and College Sports Television-debut within the next six months. What can they possibly show when everything is already on TV? You'd be amazed.

The local coroner, Chuck Fricke, performed an autopsy and determined that the cause of death was acute myocardial infarction. "Basically his heart was pumping so fast, it gave out on him," says Fricke. This explanation didn't satisfy Sean's parents, Kevin and Debbie, who questioned why a healthy, athletic 16-year-old would have a heart attack. Fricke, too, was puzzled, and ordered tests on the water of Clinton Lake, where Sean and several friends had been swimming that weekend and which is near a power plant. It was only when the school nurse starting asking around that public health officials got wind that jacketing was a common practice among Lincoln High's football players and wrestlers. Though by then it was too late to test Sean's body for ephedra--the autopsy, as was common practice at the time, included no toxicology test for ephedra--his symptoms were typical of someone who had taken a substance that stimulates the cardiovascular system. "After we heard he had taken ephedra, it all made sense," says Kevin. "As much sense as you can make of having an active, athletic 16-year-old one day and then having him drop dead the next."

They are the 900-pound gorillas of sports. While illicit steroids hijacked headlines and preoccupied governing bodies, wholly legal, over-the-counter dietary supplements pumped up and burgeoned to become a $17.7 billion business (including $1.7 billion in so-called sports-nutrition supplements). Largely outside the FDA's purview, supplements are not federally approved. They haven't been subjected to clinical trials, and often little is known about their chemical composition, side effects or efficacy. "Basically, anyone who uses these products is a human lab rat," says Dr. Arthur Grollman, a professor of pharmacological sciences and medicine at the State University of New York at Stony Brook.

But millions of athletes are taking supplements containing everything from ephedra to creatine to andro in any of several forms--pills, powders, even gums--in hopes of gaining an edge in the weight room, on the field, in the pool. "It used to be that if you wanted performance enhancement, you'd have to go to the musclebound guy at the gym who was selling steroids," says Mike Perko, an associate professor of Health and Applied Human Sciences at UNC Wilmington and author of Taking One for the Team: The New Thinking on Dietary Supplements and Young Athletes. "Now you can go to the grocery or to GNC [General Nutrition Centers] or even Smoothie King and get your supplements."

The recent deaths of Minnesota Vikings tackle Korey Stringer,Northwestern safety Rashidi Wheeler and Baltimore Oriolespitcher Steve Bechler have underscored the prevalence ofsupplement use among elite athletes. But these elixirs arehardly used by high-level athletes only. Promising somethingfor everyone--Michelangelo muscles, instant energy, washboardabs, overnight weight loss--sports supplements are in voguewith jocks at every level. Evidence suggests that the mosteager consumers are young athletes not unlike Sean Riggins. A2001 survey conducted by Blue Cross Blue Shield's HealthyCompetition Foundation indicated that approximately one millionkids had used supplements. Other experts wonder if the realnumber isn't double that. "Everyone, and I mean everyone, takessupplements now," says Southern Methodist University strengthcoach Chuck Faucette. "When a recruit comes in, the firstquestion I get is, 'What kind of supplements can I take?'"

To be sure, the lure of a college scholarship is part of the appeal. When one tenth of a second in the 40 or a few pounds on your bench-press can make the difference between a full ride and walking on, it's easy to see why athletes would swallow anything with the potential to accord a competitive advantage. The appeal of supplements crosses gender lines as it taps into teens' insecurities about their bodies. For boys, they're tailored to the ideal of adding muscle and having cinder blocks for biceps. For girls, they're often aimed at aerobic improvement and weight loss. A 2001 NCAA study revealed that ephedra, though banned in college sports, was most popular among female gymnasts (8.3%) and male lacrosse players (5.5%). "It was obvious that the women were using it to drop weight and the guys were using it for something entirely different," says Frank Uryasz, president of the National Center for Drug Free Sport and former head of drug testing for the NCAA. "Most said they started using in high school."

If young athletes are a growth sector, it's not lost on the manufacturers. The marketplace is flooded with kid-friendly supplements available in in fruity flavors and products such as Cookies 'n Creatine and Teen Advantage Creatine Serum, the latter advertised as "developed especially for young aspiring athletes 8-19." Supplement companies advertise products in magazines, on websites and on television shows--including the Little League World Series--that have a demographic that skews young. Both the ads and the packaging are awash in teen vernacular; terms such as ripped, cut, mega, Xtreme and turbo are used repeatedly.

In some cases manufacturers christen a product with a name shared by a street drug. The legal Yellow Jackets that Riggins ingested acted much like an amphetamine. But "yellow jackets" is also the nickname of a popular prescription barbiturate. Perhaps because of the confusion, NVE Pharmaceuticals, the supplement maker, decided to discontinue selling Yellow Jackets but now sells another ephedra product called Yellow Swarm, which, according to a company sales rep, "is basically the same thing with a different name." (NVE did not respond to calls seeking comment on product safety, nor to questions faxed to its New Jersey headquarters.)

Even the term dietary supplement can be confusing. It sounds innocuous, even beneficial. "What kids--especially those health-conscious and interested in sports--don't want to supplement their diet?" says Uryasz. "But the [notion] is a joke. No one is going to suffer because of an ephedra or creatine deficiency. We need to call these things what they are: drugs."

In the wake of Bechler's death on Feb. 17, there has been support for curtailing the sale of products containing ephedra. Senator Richard Durbin (D., Ill.) introduced legislation last week that would require all dietary supplements containing stimulants to prove their safety before sale. So far only one locale, New York's Suffolk County, has banned the sale of ephedra, while a handful of states, and Sean's hometown, have instituted prohibitions on ephedra sales to minors. Some stores in areas without bans have voluntarily demanded to see proof that consumers are over 18. Critics, however, wonder whether these acts could have the same effect as the Joe Camel campaign, creating a taboo that makes supplement products more desirable to teens. "GNC locks the stuff up behind the counter, but it's in a glass container, so everyone can see what's inside," says Perko. "What kid isn't going to be curious about that?" Although GNC spokesperson Stephanie Mangini described ephedra--"when used as directed"--as "a safe and effective part of a comprehensive weight-management program," she said that some GNC stores began locking up ephedra products last fall. GNC also cards potential purchasers, she says. "If these products had warning labels advising people under 18 not to take them, we thought we shouldn't sell them to [minors]," says Mangini.

Vitamin shops offer a dizzying array of products, but often young athletes don't have to venture that far for their "supps": Manufacturers have taken to enlisting coaches as distributors and pitchmen. With supplement deals springing up like shoe contracts, many big-time college athletic departments have endorsement arrangements with supplement companies. For instance, MET-Rx, a leading supplement manufacturer, has deals with more than a dozen schools, including Arizona, Florida State, Stanford, Syracuse and UCLA. (MET-Rx also sponsored ABC's college football preview show.)

AdvoCare, a Dallas-based firm, has been particularly adept at forging alliances with coaches. In fact, AdvoCare employs several current or former college coaches. For instance, Joe Hadachek was a sales rep for the company in 1999, while he was coaching football at Division III Buena Vista University in Iowa. (Hadachek, who declined to comment, resigned from Buena Vista in 1999 to work full time for AdvoCare.) Other coaches, including Oklahoma State basketball coach Eddie Sutton and SMU's Faucette, endorse the company's products on its website. AdvoCare even sells a line of products that Faucette says conforms with NCAA guidelines (which forbid not only ephedra but also steroids and amphetamines) and is overseen by Bert Hill, former strength coach for the Detroit Lions. Rachel Olander, a spokesperson for the National Center for Drug Free Sport, which has a toll-free number that pro and college athletes can call anonymously to receive information on supplements, says that many of those calls pertain to AdvoCare. "It's usually, 'My coach is telling me, Take this, but is it safe?'" says Olander. (AdvoCare did not return calls seeking comment.)

Why would a coach agree to sell or endorse a sports supplement? "When I was at the University of Texas, we had a $200,000 budget for supplements," says Faucette, who left the Longhorns for SMU in 2001. "If I can get free supplements for my kids [in exchange] for making a few appearances a year, that's really helping my budget." Says Dave Van Halanger, football strength and conditioning coach at Georgia, and also an AdvoCare endorser, "We made sure it was tested and so forth. Look at Julius Peppers [of the Carolina Panthers, the NFL's Defensive Rookie of the Year, who tested positive for ephedra and was suspended for four games last season]. He was taking a product he knew nothing about."

To others, the concept of coaches endorsing supplements, even if they are not paid by the companies, is a classic conflict of interest. "Who has more credibility with athletes than coaches?" say Uryasz. "When we speak on campuses, we're always telling administrators to be sure that their staff members aren't the pushers."

Dietary and sports supplements fall under the 1994 Dietary Supplement Health and Education Act (DSHEA), which mandates that products derived from herbs and natural sources be classified as food and not drugs. This has been a boon to supplement manufacturers, which can skip the long and often prohibitively expensive process of seeking FDA approval. (In the last two election cycles, dietary supplement manufacturers have contributed more than $3.3 million to federal candidates and political parties, according to the Center for Responsive Politics. Senator Orrin Hatch (R., Utah), who drafted DSHEA and disputes the widely held view that it shields the supplement industry from government scrutiny, was the biggest congressional recipient of industry largesse during the 2000 election cycle, with $41,750 in contributions, according to the center.

Industry critics say the current landscape is like something out of the Wild West. "If you want to start selling supplements today, you don't have to register, you don't have to show your product to be effective," says Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, a consumer advocacy organization. "Just call it natural and it's a free pass--even though there's no reason to think it's less worrisome than a chemical synthesized in a lab."

Bechler's death and the subsequent backlash have forced some supplement manufacturers to reformulate. On Feb. 27 the AMA urged the FDA to take dietary supplements containing ephedra off the market. Manufacturers, many of whom were already producing ephedra-free products, moved to market those alternatives more heavily. Supplements laced with such stimulant alkaloids as bitter orange (also known as synephrine) promise results similar to those of ephedra, though there exists little conclusive evidence that these substitutes are any more or less harmful.

For some supplement manufacturers and researchers, this remarkable lack of data can make for an effective defense. "When you have random reports and no clinical tests, you don't know what the normal occurrence would be if people hadn't been taking supplements," says Richard Kreider, a professor and director of the Exercise and Sport Nutrition Lab at Baylor. "It's been reported that Americans take three billion doses of ephedra a year. If there was a huge problem, we should have seen more reports."

Kevin Riggins struggles to wrap his brain around this line of reasoning. "[The manufacturers] should have to prove that supplements are safe and effective," he says. "Consumers shouldn't have to prove they're ineffective and can kill you." A muscular 38-year-old with a goatee and tattoos, Kevin knew virtually nothing about supplements before Labor Day of last year. Today he is an expert--"not by choice," he is quick to add. He works 40 hours a week at the Bridgestone/Firestone tire plant up the road in Bloomington, Ill., and spends the balance of his time running the Sean Riggins Foundation for Substance Free Schools. Sean's small bedroom, still festooned with martial-arts trophies and posters of muscle cars, serves as the foundation's headquarters.

Wearing Sean's green number 51 home jersey, Kevin speaks to numerous high school kids around Illinois. He is in frequent contact with Durbin regarding his legislation to ban ephedra. "The foundation was the best way I could think of to honor Sean," says Kevin. "The basic message is that these supplements can be dangerous and that chemicals don't enhance sports performance."

Kevin has no delusions about the scope of the challenge. He knows how deeply supplements are embedded in today's sports culture. And he knows that thriving, multibillion-dollar businesses are not in the habit of rolling over. But his jaw tightens when he hears manufacturers defend their products on the grounds that reports of any injuries and deaths merely constitute anecdotal evidence. "We're talking about kids here, not anecdotes," he says. "I refuse to let people dismiss Sean as 'anecdotal evidence.' He was a great kid, and he should be finishing wrestling season right now."

COLOR PHOTO ILLUSTRATION: ILLUSTRATION BY KEVIN IRBY/COURTESY THE RIGGINS FAMILY ENDGAME Sean's body wasn't tested for ephedra, but friends say the 16-year-old took a supplement containing that substance the day before he died.COLOR PHOTO: DARREN CARROLL WEIGHTY ISSUE SMU's Faucette says endorsement deals such as the one he has with AdvoCare help a school's bottom line.FIVE COLOR PHOTOS: PETER GREGOIRE (5)COLOR PHOTO: MEL LEVINE (HGH)COLOR PHOTO: JONATHAN DANIEL A DAD'S MISSION Kevin uses Sean's room as the home base of his fight for substance-free schools.

THE INSIDE STORY

What's in that pill you're about to pop or that drink you're ready to chug? A guide to some common ingredients in sports supplements and their potential dangers

EPHEDRA

An extract of the Chinese plant ma huang that stimulates cardiovascular and central nervous systems

FOUND IN Weight-loss, energy-boosting and bodybuilding products, including Stacker 2 and Metabolife 356

POTENTIAL RISKS Can cause elevated blood pressure. When taken in excessive doses or by people with certain medical conditions, can result in cardiac arrhythmia, heart attack, seizure or stroke